I envy this generation of students for having the internet at their fingertips. It would have made our own student years so much easier. It must be so wonderful for students today to find answers in an instant.

In our second MBBS year, after having been cosseted away from the real world of clinical medicine with para-clinical subjects in Bambolim, we were let loose on patients in the wards in Panjim and Ribandar. Armed with Hutchison’s Clinical Methods we began to learn first-hand how to take a clinical history and conduct a thorough examination. We encountered a bewildering array of exotic and (to us at that time) obscure terms and conditions in our study.

The ones I’d like to focus on in this article are: Sydenham’s chorea, choreoathetosis and Saint Vitus dance. The reference to ‘dance’ and ‘Saint Vitus’ intrigued me. And who was Sydenham? Some medical pioneer of sort, perhaps. As Catholics, and having studied in a Catholic school, I knew my fair share of saints, but this was a new one. And what did he have to do with a neurological disorder, I wondered. Curiouser and curiouser.

But medical school doesn’t really reward you for such speculation. As I said before, I had other –ologies to deal with, so etymology took a remote, back seat. I don’t think I ever saw a clinical case of Sydenham’s chorea, so as long as I just memorised it as another cause of involuntary movements, I was fine.

Ironically, around that time, I was being exposed to tarantella music (I had a scratchy recording of Yehudi Menuhin playing Wieniawski’s Scherzo Tarantelle; and although I didn’t know it by name, I had watched the wedding guests dance a Tarantella Napolitana in the cult 1972 American mafia film, Francis Ford Coppolla’s The Godfather) but, very much like the Hindi masala films popular at that time where everyone is related but blissfully unaware until the very end, I didn’t realise everything was connected.

The pieces of the puzzle fitted together gradually over time. I learnt that chorea itself is derived from the ancient Greek ‘choreia’ (from which we also get the word choreography) meaning ‘dance’.

Then in my UK years, a TV documentary on the ‘dancing mania’ that swept through Europe between the 14th and 17th centuries caught my attention. It seemed really bizarre; apparently outbreaks of collective dancing, sometimes running into thousands of men, women and children, just dancing nonstop until they collapsed from fatigue. (Today’s flash mobs and full-moon parties would be hard-pressed to match such numbers). I learnt of the notorious ‘dancing plague’ in 1518 in Strasbourg, affecting hundreds of people, many of whom died from the exertion. And in this documentary, Saint Vitus was mentioned, which made me pay closer attention. At last this mystery would be solved.

Vitus was an early Christian martyr saint from Sicily, and regarded as one of the Fourteen Holy Helpers in Roman Catholicism as their intercession was effective against different diseases, a tradition that began in response to the bubonic plague or Black Death (1346-1353) in Europe. Saint Vitus was specifically invoked against epilepsy. His feast day 15 June was observed in Germanic and Latvian cultures by dancing before his statue, which is how his name got lent to neurological disorders involving involuntary, ‘dance-like’ movements.

Pieter_Bruegel_de_Oude_-_De_bruiloft_dans_(Detroit)

What caused these dancing en masse outbreaks, though? Theories abound, from sorcery and demons to ergot poisoning, a religious cult (revival of ancient Greek and Roman pagan rituals), to a mass psychogenic illness or epidemic hysteria, collective stress-busting and escapism as a means of momentarily forgetting their poverty and troubles.

In Italy, as it was believed to have been caused by the bite of a tarantula spider or scorpion, it was known as tarantism. Other sources state that dancing was thought to be the only antidote to a tarantula bite, the strenuous activity allowing the venom to separate from the blood. And the typical music the victims (‘tarantolati’) would dance to was called the tarantella.

As might be expected, they are energetic dances, in triplet time, usually 6/8 although sometimes even more complex. The dancer and the tambourine or drum player each up the ante trying to outperform the other, until one concedes defeat from exhaustion.

Examples in classical music abound. Wieniawski arguably derived inspiration for his Scherzo-Tarantelle from Chopin’s Tarantelle in A flat Opus 43 for piano, in turn inspired by Rossini’s song ‘La Danza’, also a tarantella.

The last movement of Mendelssohn’s fourth symphony (the “Italian”) is in the form of a tarantella.

Liszt inserts one (“Tarantella, Venezia e Napoli) in his Années de Pélérinage or Years of Pilgrimage (2nd year: Italy).

The finale of Schubert’s Death and the Maiden string quartet is a tarantella, a dance of death or a danse macabre, a fitting ending to a death-absorbed work.

(Here is the Kelemen string quartet playing it during their tour of India, which also included Goa).

Tchaikovsky also appropriately uses a tarantella to close his Capriccio Italien, and one of his Pas de Deux in his Nutracker ballet is also a tarantella, complete with jangling tambourines.

The spider itself (wolf spider) got its name tarantula (lycosa tarantula) from the south Italian town on Taranto where it was commonly found. The term got loosely applied to other large ground-dwelling spiders. Despite the hype around them, their bites although venomous are not fatal to humans, and they themselves are prey to larger predators. 12 March is apparently World Spider Day, so a closer look at arachnids might be appropriate.

And I did eventually find out who Sydenham was. British physician Thomas Sydenham (1624-1689) was nicknamed ‘The English Hippocrates’ for having authored ‘Observationes Medicae’ which became a standard medicine textbook for two centuries. He ‘discovered’ the disorder which today bears his name. Also known as rheumatic chorea, it is characterised by rapid, uncoordinated jerking movements affecting primarily the face, hands and feet and occurs following childhood infection with Group A beta-haemolytic Streptococcus.

(An edited version of this article was published on 12 March 2017 in my weekend column ‘On the Upbeat’ in the Panorama section of the Navhind Times Goa India)

Advertisements